When doctors have a simulated operating room

Chapter 92

The author was not allowed to have a good surgery.

Then Zhang Yi would definitely not let the author get away with it!

So he had to do this surgery!

In the operating room.

Tang Xiaocheng took all the girl's checkup sheets and prepared to give them to Zhang Yi to take a look.

But Zhang Yi skipped him!

He went straight to the operating table and started to observe.

Zhang Yi looked and asked:

"Doctor Tang, which blood vessels and nerves are missing?"

Li Cheng explained quickly:

"The small saphenous vein and popliteal artery were not found on both sides of the broken limb, and the lateral sural cutaneous nerve was also missing."

"In addition, the tibia and fibula were severely crushed. If the right leg was really connected, it would be shorter than the left leg."

Zhang Yi nodded.

In his sight, he did not see these blood vessels and nerves.

Then Zhang Yi walked to another operating table.

He took the distal limb to the operating table.

Then, he made another careful comparison and inspection.

Before starting the operation, he must ensure that the other blood vessels in the calf of the limb are not damaged.

Otherwise, after the leg is connected and blood flow is restored, it is found that the blood vessels are actually damaged.

(The calf will be partially bulging)

The connection is in vain.

Looking at Zhang Yi's actions.

A trace of surprise flashed across Tang Xiaocheng and Li Cheng's faces.

Doesn't this guy even look at the CT film?

Just observe directly like this?

You have to see how the bones are broken up and down, right?

However, Zhang Yi observed very seriously, and the two did not interrupt him.

After a while, the situation was understood.

Zhang Yi was ready to start the operation.

"Start with bone setting, prepare more Kirschner wires and intramedullary needles."

Listening to Zhang Yi's instructions, Li Cheng was a little puzzled.

How to talk about the problem of blood vessels and nerves?

"That... Doctor Zhang, the missing blood vessels?"

Zhang Yi lowered his head and picked up the tools in the instrument tray while saying:

"The popliteal artery and the small saphenous vein can be replaced by blood vessels in the feet and hands, which are not particularly important blood vessels at the end of the body."

"For nerves, you can choose to graft, but you can also choose to ignore them.

Although the lateral sural nerve is gone.

But the superficial peroneal nerve is still there, and the gastrocnemius and soleus muscles are still there, which can support the calf."

Li Cheng was stunned: "Ah?!"

This is also possible? !

What if you find that your legs are numb and can't move after the operation? !

This is too casual!

Li Cheng certainly can't understand it.

Because Zhang Yi's method is the result of many times of practice in the simulated operating room.

The system will not only evaluate whether Zhang Yi's operation method is standardized.

It will also evaluate whether the operation is successful.

Zhang Yi has already scored full marks in the operation of replanting severed limbs.

So he is very confident.

"Let's get started."

Li Cheng looked at Tang Xiaocheng next to him again.

Tang Xiaocheng gave him a reassuring look:

Trust him!

He's really a big shot!

Finally, Li Cheng sighed and began to serve as an assistant to Zhang Yi.

Bone setting should start with the big bones.

Kirschner wire, intramedullary needle, and cross wire first connect the thicker tibia.

There are two bones in the calf.

One is thick and the other is thin.

The tibia is thick and plays a load-bearing role.

The fibula is thin and located behind the tibia. It plays an auxiliary support role and participates in the formation of the ankle joint.

"Change to drill bit No. 3."

"Okay."

Buzz!

After a while, a slight electric drill sound was heard in the operating room.

Drill a hole in the tibial tuberosity to prepare for the placement of an external fixator later.

The girl's tibia and fibula were broken into ten pieces of different sizes.

After removing the washed bone residue, Zhang Yi tried his best to piece the bones together.

Buzz!

Watching Zhang Yi's skilled operation.

People around were stunned!

How old is this handsome guy?

He looks so young...

How can he operate so well? !

There are also regular trainees and attending doctors who are learning from Li Cheng in the operating room.

Seeing Zhang Yi's skills, they all felt inferior.

A young doctor couldn't help but be curious, walked to Tang Xiaocheng and asked:

"Teacher Tang, which big hospital is this doctor from?"

Tang Xiaocheng shook his head:

"He is from the People's Hospital next door."

Shocked jpg!

I knock!

People's Hospital actually has such high-tech talents? !

It must have cost a lot of money to invite them!

Alas, the Second Hospital is reluctant to spend money!

So it has always been better than

The People's Hospital is a little bit worse.

On the operating table, the step of fixing the tibia and fibula is still going on.

After the large skeleton is fixed, the intramedullary nail is used to fix the smaller bones.

The bones on both sides of the cross section have been smoothed for easy docking.

After the docking is completed, the fixation is strengthened with steel wire.

Before suturing the tendons and blood vessels.

Then, the screws for the external fixator are made on the left and right sides above the cross section and five centimeters above the ankle.

Both the placement of external fixators and internal fixation plates are options for orthopedic surgery.

The internal fixation plate needs to be removed by surgery again later.

The external fixator is not needed.

However, the choice of surgical method is determined by the patient's own situation.

The girl has a comminuted fracture.

In order to splice the broken bones, more than a dozen Kirschner wires and intramedullary nails have been used inside.

If a steel plate is added, it is easy to affect the existing fixation effect.

(Adding a steel plate requires drilling screws in)

So using an external fixator to fix the entire calf is currently the best choice for girls.

After the tibia and fibula are fixed, the tendons are sutured.

There are many ways to suture tendons, such as 8-shaped suture, loop suture, stainless steel wire suture, Kessler suture, Bunnell suture, etc.

But Zhang Yi's suture...

It opened Li Cheng's eyes!

What kind of suture is this? !

It looks like both loop suture and Kessler suture? !

I've never seen it before...

Zhang Yi saw the confusion on Li Cheng's face and explained:

"This is my own modified Kessler suture method, which combines cross suture and three-loop suture.

The requirement for tendon suture is that it must be tight and leave no gaps, otherwise it will affect the healing time or the tendon tension will be too strong and cause the tendon to break again.

So I came up with a suture method that combines Kessler and cross loops.

The action must be gentle, and do not damage the remaining tendon tissue.

After suturing, cover it with surrounding soft tissue, so that it is not easy to cause adhesion."

Zhang Yi did not stop while explaining the action of his hands.

As soon as he finished speaking, his suture was just finished.

Li Cheng didn't know what to say.

Several young doctors next to him could only shout at Zhang Yi: Big Boss 666~

While secretly sighing when they could be as awesome as this great god...

Next is the blood vessel.

A seven-centimeter-long blood vessel was taken from the dorsal vein of the foot to graft the small saphenous vein.

Zhang Yi chose the radial artery in the arm to replace the popliteal artery.

There is a brachial artery at the upper end of the arm, which starts to branch at the elbow.